The Novel Predictive Biomarkers for Type 2 Diabetes Mellitus in Active Pulmonary Tuberculosis Patients

Abstract

Purpose This study was to explore the predictive value of monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophils to high-density lipoprotein cholesterol ratio (NHR), C-reactive protein-to-lymphocyte ratio (CLR), and C-reactive protein-to-albumin ratio (CAR) for type 2 diabetes mellitus (T2DM) in patients with active pulmonary tuberculosis (APTB). Patients and Methods A total of 991 active pulmonary tuberculosis (APTB) patients (201 with T2DM) were hospitalized in the Department of Tuberculosis, Wuhan Jinyintan Hospital, Tongji Medical College, Huazhong University of Science and Technology were included. The routine blood examination indicators and biochemical parameters were collected to calculate MHR, NHR, CLR, and CAR. The Pearson correlation analysis, Univariate Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were performed to assess the predictive value of MHR, NHR, CLR, and CAR for APTB-T2DM patients. Results The levels of MHR, NHR, CLR, and CAR in the APTB-T2DM patients were significantly higher than in the APTB-no T2DM patients (P < 0.05). Additionally, the MHR, NHR, CLR, and CAR have a positive correlation with fasting blood glucose in the whole study population. However, in the APTB-T2DM patients, MHR, NHR, and CAR were not correlated with fasting blood glucose, and only CLR was positively correlated with fasting blood glucose. The area under curve (AUC) predicting APTB-T2DM patients of the MHR, NHR, CLR, and CAR was 0.632, 0.72, 0.715, and 0.713, respectively. Further, univariate logistic regression analyses showed that the higher MHR, NHR, CLR, and CAR were independent risk factors for APTB-T2DM (P < 0.01). The MHR, NHR, CLR, and CAR quartiles were used to divide the APTB patients into four groups for further analysis. The prevalence of T2DM was significantly higher in APTB individuals as MHR, NHR, CLR, and CAR values increased (P < 0.05). Conclusion MHR, NHR, CLR, and CAR are simple and practicable inflammatory parameters that could be used for assessing T2DM in APTB. APTB patients have a greater possibility to be diagnosed with T2DM with the higher MHR, NHR CLR, and CAR values. Therefore, more attention should be given to the indicator in the examination of APTB.

Risk Prediction for Rapidly Progressive Interstitial Lung Disease in Anti-MDA5-Positive Dermatomyositis: The CRAFT Model

“…CAR is a better marker for inflammation and nutritional status than CRP or albumin alone. Qi et al found that CAR is a useful marker to predict diabetes mellitus in patients with pulmonary tuberculosis [ 25 ]. Interestingly, there have been no studies that investigated the correlation between CAR and RP-ILD, to the best of our knowledge.…”

“…The red blood cell distribution width (RDW), a simple index in peripheral blood circulation, reflects the size heterogeneity of red blood cells, commonly used for differential diagnosis of anemia [ 26 ]. Several studies have demonstrated that elevated RDW is correlated with inflammatory status in various diseases [ 27 , 28 ].…”

The survival analysis of rifampicin/multidrug-resistant tuberculosis patients based on the levels of inflammatory biomarkers: a retrospective cohort study

“…For example, high-sensitivity C-reactive protein to lymphocyte ratio (HSCLR) was proven to be an important biomarker for distinguishing active PTB from inactive PTB ( Yu et al., 2022b ). Similarly, CLR can be used to predict the prevalence of T2DM in patients with active PTB ( Yu et al., 2022a ). To our best knowledge, the current study is the first to explore the correlation between CPR and prognosis of TB.…”

Relationship Between Clinical, Laboratory, and Radiological Symptoms with The Incidence of Active Pulmonary Tuberculosis in People with Type 2 Diabetes Mellitus

“…Studies show that there is an increase in monocytes, neutrophils and a decrease in serum lymphocytes in type 2 DM patients with active pulmonary TB infection [5]. Studies also show that pulmonary TB infection in people with type 2 diabetes can affect immune system disorders, especially the cellular components, namely Neutrophil Lymphocyte Ratio (NLR) and Monocyte Lymphocyte Ratio (MLR) which are used as markers of pulmonary TB infection (Yu et al, 2022) [6].…”

“…Lacerda (2017) also said that the inflammatory response in TB suppresses leptin production directly through loss of body fat mass and decreased energy intake, decreased leptin leads to decreased cellular immunity [36].. According to Yu et al, (2022) leptin is a proinflammatory hormone found to be significantly increased in DM and TB patients [6].…”